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Your guide to Kidney Health:
Understanding the risks, diagnosis and treatment

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1.What is the kidney?

Kidneys are small bean-shaped organs which are located behind the belly and under the ribs. There are two kidneys and each one is located on either side of the spine. The size of each kidney varies from 4 to 5 inches which are roughly the size of a fist.

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2.What function does the kidney perform?

What function does the kidney perform

The kidneys consist of many small filters called nephrons and its purpose is to purify the blood by extracting waste out of the blood and the waste is converted into urine. This urine is accumulated in the kidney's pelvis and then passed through a tube called the ureter and the bladder. This helps in balancing body fluids and levels of electrolytes in the body. This process continues several times a day. Kidneys are vital organs which help in maintaining healthy salt, pH, phosphorus and potassium levels in the body. They also generate enzymes called renin which adjusts blood pressure levels. It monitors the production of red blood cells by making a chemical called erythropoietin and helps in absorbing calcium for healthy bones and teeth.

Once the kidney is damaged the filtering of blood is halted which leads to piling up of fluids and waste in the body and this shows out symptoms such as poor sleep, nausea, shortness of breath, weakness and swelling in the ankles. Kidney needs to be treated to prevent further damage, if ignored it can lead to serious health issues and even death.

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3.Types of kidney diseases and problems

Chronic Kidney Disease- This is the most common type of kidney disease. When the kidneys stop functioning for a longer period like 3 months or more it is called chronic kidney disease. This is generally caused due to high blood pressure in the body. Maintaining blood pressure levels in the body is very important as increased blood pressure damages glomeruli in the kidneys which leads to kidney failure. The tiny blood vessels that clean blood in the kidneys are called glomeruli. Chronic kidney disease can also be caused due to diabetes. High sugar levels cause severe damage to blood vessels in the kidneys. Once the condition is diagnosed the patient is advised to undergo dialysis. Dialysis is a process that helps in extracting extra waste and fluids from the blood. This process can help kidneys to perform better but it cannot cure the disease.

Kidney Stones - Kidney stones are formed due to crystallisation of minerals and other substances absorbed from the blood. These kidney stones are discarded from kidneys through urination when they are small and tiny. However, the condition worsens and becomes difficult to pass through urine when the stones grow big. This causes severe pain and needs medical attention to cure the condition. This disease is curable and does not cause major health hazards.

Glomerulonephritis - This is a condition caused due to swelling of tiny blood vessels in the kidneys called glomeruli. Glomeruli filter blood that passes through the kidneys. Glomerulonephritis is caused due to allergies from drugs, infections or a disorder which occurs shortly after birth. Glomerulonephritis does not need any treatment and heals on its own.

Polycystic kidney disease - Growth of many small cysts filled with fluids in the kidney are called polycystic kidney disease. This is usually a genetic disorder passed on from ancestors. The kidney function is interrupted by these cysts leading to kidney failure. This is a serious issue and needs medical attention. Individual cysts are also formed in kidneys but these are very common and non-hazardous when compared to polycystic.

Urinary tract infections - An infection caused in the urinary system is called Urinary tract infections also known as UTIs. Most often urinary infection begins in the bladder and urethra. This infection is very common and can be cured easily, however, if left untreated it can cause serious health issues and kidney failure.

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4.Signs and symptoms of kidney disease

Kidney diseases show no symptoms in the beginning stages and they only become evident in the final stages. Some of the most common symptoms of kidney diseases are-

  • Pressure and pain in the chest.
  • Poor sleep
  • Difficulty in breathing
  • Dry and scaly skin
  • Frequent urination at night
  • Swelling around the eyes
  • Loss of appetite
  • Swollen ankles and feet
  • Muscle cramping
  • Insufficient sleep
  • Tiredness
  • Poor Concentration

Once the condition gets severe other symptoms develop such as-

  • Changes in urine output
  • Decreased sex drive
  • Hike in potassium levels, this condition is called hyperkalemia
  • Anaemia
  • Fluid retention
  • Vomiting and nausea
  • Swelling in the fluid sac that covers the heart called pericardium.

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5.Risk factors for kidney Disease

Risk factors for kidney Disease

Diabetes - The increased sugar level in the body damages blood vessels and filters in the kidneys that purifies the blood. This leads to the retention of more blood and water in the body and accumulates more wastes. This causes nerve damage and blocks urine from passing out which leads to kidney failure.

High Blood Pressure - Increased blood pressure causes severe damage to blood vessels in the entire body. Increased blood flow weakens and scars the blood vessels in the kidneys and stops it from discarding waste from the blood. The accumulation of extra fluids, in turn, raises blood pressure level causing severe damage to kidneys. High blood pressure can be treated through medicines and by bringing lifestyle changes like diet, exercise and stress levels.

Lupus - It is a condition that allows the immune system to attack a few parts of the body including the kidneys. The condition affecting the kidneys are called lupus nephritis. This causes severe damage to blood vessels in the kidneys by scarring and swelling of blood vessels. This can be cured through medications to correct the immune system and blood pressure levels.

Anorexia Nervosa - This condition is found in people who are anaemic and those who weigh 15% less than their ideal body weight. This is caused due to lack of salt and water in the body which leads to severe damage and kidney failure.

Multiple Myeloma - In multiple myeloma, excessive production of white blood cells in bone marrow overshadows healthy blood cells. These cancer cells produce abnormal proteins that affect the kidneys and cause kidney failure.

Hemolytic Uremic Syndrome - This condition is caused due to piling of red blood cells in the kidney's filtering system that leads to kidney failure. The most common symptom of Hemolytic Uremic Syndrome is continuous diarrhoea for 4 to 5 days. Seek medical help if you are feeling tired and unable to pass urine with continuous diarrhoea for several days. This condition can be cured with medication if diagnosed earlier.

ANCA Vasculitis - This kidney problem is caused when small blood vessels of kidneys and other organs are attacked by the body's antibodies which fight germs. This allows the blood and proteins to mix up with urine and leads to kidney failure. The condition can be identified with certain symptoms such as joint and muscle pain, high fever, body aches, brown or tea-coloured urine.

Urine Blockage - When you face difficulty in passing urine this could be mean the urine is blocked. Blocking of urine can cause several kidney disorders by increasing pressure and infection in the kidneys. This condition could also occur due to another underlying disease such as kidney stones, prostate cancer, colon cancer, bladder cancer, blood clots in the urinary tract, etc. It needs medical attention and can be cured with medication if diagnosed earlier in certain conditions.

Blood Clots - Blood clots in the kidney caused due to blood disorder called thrombotic thrombocytopenic purpura can lead to severe kidney damage. It is a condition in which the heart and brain are affected too. It can lead to serious health issues if it is not treated at the earliest. Some of the usual symptoms of this disease is bleeding from nose and gums, fever, tiredness, nausea, severe headache, chest pain, bruising and diarrhoea.

Scleroderma - This kind of disease affects the blood vessels and connective tissues and are rarely found. It hardens and tightens the blood vessels and connective tissues which affects the kidneys by leaking proteins into the urine. This increases blood pressure levels and leads to rapid kidney failure.

Polycystic Kidney Disease - The presence of several small lumps filled with fluid in the kidney is called polycystic kidney disease. This is a condition acquired genetically that leads to swelling in kidneys. If not treated at the earliest it could lead to severe kidney damage and will eventually lead to kidney failure.

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6.How to keep your kidneys healthy

A healthy kidney can be maintained by leading a healthy lifestyle. Following a healthy diet and leading a stress-free life can improve the functionality of kidneys. Here are a few tips to keep your kidneys healthy-

  • Avoid food which increases cholesterol levels
  • Keep blood sugar levels under control and take proper medication to control them if affected by diabetes.
  • Reduce the intake of salt.
  • Eat a balanced diet that includes the intake of fresh fruits and vegetables, low- dairy products and whole grains.
  • Quit smoking
  • Exercise regularly
  • Do not overdrink. Keep alcohol consumption under control.
  • Reduce weight if you are suffering from obesity.

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7.Diagnosis of kidney disease: Essential Tests

As soon as you see the signs and symptoms of kidney problems you need to consult a doctor. The doctor will put you through a series of tests to diagnose the problem further. Here are a few important procedures followed to diagnose kidney disease.

Glomerular filtration rate (GFR) - This is a test done to monitor the filtration rate of the kidney and its functions to determine the stage of the disease.

Urine analysis - The urine sample is observed under a microscope to look for bacterial infections, bleeding and other signs of kidney problems.

Kidney Ultrasound - Ultrasound of kidneys give out clear images of the kidneys with the help of a probe which is placed on the skin to create images of the kidney with the help of sound waves. These images show damage in kidneys such as blockage of urine, the appearance of stones and cysts.

Computed tomography (CT) scan - A CT scan helps to take sectional pictures of the organs through X-ray which gives out clear details of the problem in kidneys.

Kidney biopsy - A small piece of the tissue is extracted from the diseased kidney in this procedure. The sample obtained is further studied under a microscope to conclude the severity of the issue. This procedure is followed after you are sedated with local anaesthesia.

Magnetic resonance imaging (MRI) scan - High-resolution images of the kidney is captured through a scanner which emits radio waves in a magnetic field. This helps the doctor to diagnose the problem with great clarity.

Blood creatinine test -A blood analysis is done to check the level of creatinine in the blood. Creatine are waste products of molecules present in the muscles called creatine. The increased level of creatinine in the blood helps in diagnosing the severity of the issue.

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8.Treatment of kidney disease

Treatment of kidney diseases

Most often kidney diseases are caused due to another underlying issue such as diabetes, cholesterol or high blood pressure levels. Kidney diseases are easy to cure when diagnosed earlier and the survival rate is high. Doctors provide treatments depending on the severity of the disease. This means not all kidney disease patients will undergo the same treatment. Some of the effective treatment methods for kidney problems are -

Antibiotics - Depending on the results of your blood and urine test your doctor will prescribe antibiotics to fight against bacteria. This is called antibiotic therapy.

Nephrostomy -It is a procedure followed to drain out the urine blocked in the kidneys and further relevant treatment is provided to clear the blockage. This procedure is done by passing a catheter through the skin to reach the kidneys.

Lithotripsy - This procedure is done by a machine to project ultrasound shock waves that pass through the body to break large kidney stones into small pieces. These small pieces can easily pass through urine later.

Nephrectomy - This is a surgery performed in patients suffering from kidney cancer and other severe kidney problems. The damaged kidney is removed completely during this surgery.

Dialysis - It is a method followed to purify the blood with the help of machines. This procedure is done when the kidneys are close to failing or damaged completely. It is a repetitive process which should be done once in a few days or weeks. This is process is done until you find a donor. There are two types of dialysis-

  • Hemodialysis - In this type, the impure blood from your body is pumped into a machine that helps in extracting all the impurities and passes the pureblood back to the body. This procedure can be done at home or in a hospital according to your convenience. The procedure is repeated thrice a week. Some common side effects of this dialysis are muscle cramping, low blood pressure and itching.
  • Peritoneal dialysis - This procedure is conducted by passing a large amount of fluid called dialysate into the abdomen through a catheter. Waste products are passed from the kidneys through the peritoneum (a membrane that covers the abdominal wall ) to reach the fluid in the abdomen. Once the fluid collects all the waste products it is later extracted out of the abdomen and discarded.

Kidney transplant - It is a procedure done when both kidneys fail. Transplantation of a kidney can bring back life to normal. This is done by obtaining a healthy kidney from a living or a deceased organ donor.

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9.Understanding kidney failure

Kidney failure is a condition occurs when the kidneys lose their capabilities to filter impurities from the blood. This is often caused due to an underlying reason like -

  • Exposure to toxic chemicals and medications
  • Severe dehydration
  • Acute and chronic diseases like diabetes, high blood pressure, cancer, etc
  • Kidney trauma

Kidney failure is classified into five types, which are-

Acute intrinsic kidney failure - A condition that damage the kidneys directly through trauma such as an injury or an accident is called acute intrinsic kidney failure. This trauma raises the level of toxins and ischemia in kidneys and reduces the flow of oxygen in them leading to kidney damage.

Acute prerenal kidney failure - Acute prerenal kidney failure occurs when the kidneys are not supplied with sufficient blood flow. Kidneys require adequate blood flow to remove toxins from the blood. Blood flow can be obstructed due to several other underlying diseases which will show up during diagnosis.

Chronic prerenal kidney failure - When the kidneys do not receive blood supply for a long time they begin to shrink and stops functioning further. This condition is called Chronic prerenal kidney failure.

Chronic intrinsic kidney failure - This condition occurs when kidneys are being affected for a longer period due to intrinsic kidney disease. This leads to a lack of oxygen and severe bleeding in kidneys.

Chronic post-renal kidney failure - When urine is blocked for a long term in kidneys it raises pressure levels in kidneys to cause kidney failure.

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10.Stages and prognosis

There are five stages of kidney failure. The symptoms and severity of the disease get complicated at the later stages.

Stage 1 - At this stage, the condition is not severe and symptoms are not visible. Recovery from damage is very easy by bringing healthy lifestyle changes into practice.

Stage 2 - The condition is still mild with very little or no symptoms shown. This condition is mostly diagnosed during a urine test where an increase of protein level is identified in urine. The disease is curable by bringing healthy lifestyle changes and by consulting a doctor for medications.

Stage 3 - At this stage, 50% of the kidney is damaged and evident symptoms can be seen. This condition can be treated by medication to stop further damage and you will be advised to bring in some healthy lifestyle changes.

Stage 4- At this stage kidney failure is severe but hasn't stopped working completely. This condition needs immediate medical attention and treatments to slow down the damage. The condition is difficult to reverse at this stage.

Stage 5 - Kidney are close to complete failure or they stop working entirely. The survival rate at this stage is very difficult unless there is a kidney transplant. Patients at this stage undergo dialysis regularly to survive.

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11.Kidney Health FAQs: All your concerns addressed

Q.   How long can I live with chronic kidney disease (CKD)?

  1. Living with CKD depends on your age, other health problems, and how involved you become in your care. Most people with early CKD will never have kidney failure. Others will reach kidney failure and may live for decades with dialysis or kidney transplants. The survival rate for kidney diseases depends on treatment methods and healthy lifestyle habits.

Q.  How does diet affect kidney function?

  1. One way to preserve your kidney function is to modify your diet. Proper nutrition can reduce the workload of the kidneys and preserve or delay further progression of your kidney disease. A renal dietitian can help you make good choices with the foods you normally eat and make suggestions on foods to add and foods to moderate in your diet. The dietitian is an important part of your healthcare team and can assist you in living well with chronic kidney disease.

Q.  Can I still have a good life if I need dialysis?

  1. Yes, you can live long and live well with dialysis. It is often observed that people who are very sick before they start dialysis feel much better a few weeks or months later. Feel free to consult a doctor to clear all your doubts on kidney dialysis.

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